Ariz. Admin. Code § R9-16-311 - Responsibilities of a Hearing Aid Dispenser
A. A licensee, except for a hearing aid dispenser with a
temporary license, shall submit a renewal application in a format provided by
the Department that contains:
1.
For an individual licensed as a hearing aid
dispenser:
a.
The applicant's name, home address, telephone
number, and e-mail address;
b.
The applicant's Social Security Number, as required
under A.R.S. §§ 25-320 and 25-502 ;
c.
If applicable, the name of the applicant's employer
and the employer's business address and business telephone
number;
d.
The applicant's license number and expiration
date;
e.
Since the hearing aid dispenser's previous license
application, whether the applicant has been convicted of a felony or a
misdemeanor involving moral turpitude in this or another state or
jurisdiction;
f.
If the applicant was convicted of a felony or
misdemeanor involving moral turpitude:
i. The date of the
conviction,
ii. The state or jurisdiction of
the conviction,
iii. An explanation of the crime
of which the applicant was convicted, and
iv. The disposition of the
case;
g.
Whether the applicant has had a license revoked or
suspended by any state within the previous two years;
h. Whether the applicant is
currently ineligible for licensure in any state because of a prior license
revocation or suspension;
i. Whether any disciplinary
action has been imposed by any state, territory or district in this country for
an act upon the applicant's hearing aid dispenser license;
j. An attestation that
information required as part of the application has been submitted and is true
and accurate; and
k. The applicant's signature and
date of signature;
2.
In addition to the requirements in subsection (A)(1)
an individual shall submit:
a. Documentation of 24 continuing
education hours completed within the 24 months before the expiration date on
the license, including:
i. The name of the organization
providing the course;
ii. The date and location where
the course was provided;
iii. The title of each course
attended;
iv. A description of each
course's content;
v. Whether the course was taught
in-person;
vi. The name of the
instructor;
vii. The instructor's education,
training, and experience background, if available; and
viii. The number of continuing
education hours earned for each course; and
b. A $200 license renewal fee;
or
3. For a business organization
licensed as a hearing aid dispenser:
a.
The information in subsection R9-16-308(A)(1),
and
b.
A $200 license renewal fee.
B.
A licensee, except for a hearing aid dispenser with
a temporary license, who renews a license within 30 calendar days after the
expiration date of the license, shall submit to the Department:
1.
The information and renewal fee required in
subsection (A), and
2.
A $25 late fee.
C.
A renewal license issued to a licensee, except for a
hearing aid dispenser with a temporary license, is valid for two years after
the expiration date of the previous license issued by the Department.
D.
If a licensee does not comply with subsections (A)
or (B), the license is nonrenewable and:
1.
The hearing aid dispenser may apply for a new
license according to subsection (E), or
2.
The business organization may apply for a new
license according to R9-16-308 .
E.
A licensee whose license is nonrenewable according
to subsection (D)(1) and it is within one year after the expiration date of the
hearing aid dispenser's license:
1.
The applicant shall submit an application in a
format provided by the Department that contains:
a.
The information required in R9-16-304(A)(1) through
(A)(4), and
b.
Documentation of continuing education according to
R9-16-312 ; and
2.
A nonrefundable $100 application fee and a $100
license fee.
F.
If allowed in R9-16-309(E)(1), a hearing aid
dispenser with a temporary license shall submit at least 30 calendar days
before the expiration date on the license, a renewal application in a format
provided by the Department that contains:
1.
The information in R9-16-304(A)(1) through (A)(4)
;
2.
The applicant's sponsor's:
a.
Name,
b.
Business address,
c.
Business telephone number, and
d.
Arizona hearing aid dispenser license
number;
3.
A statement signed by the sponsor that the sponsor
is a licensed hearing aid dispenser who agrees to train, supervise, and be
responsible for the applicant's hearing aid dispenser practice according to
A.R.S. § 36-1905 ; and
4.
A $100 license renewal fee.
G.
A renewal license issued to a licensee according to
subsection (F) is valid for one year after the expiration date of the previous
license issued by the Department.
H. The Department shall review a renewal application according
to R9-16-316 and Table 3.1.
Notes
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